| NPI | 1942450218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L MILLER President 617-894-4220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 21541) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: MA 21541) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2008-09-24 |